Biomedical subjects
Publications and source records attributed to T Hosaka.
A recent comment by I. Alex Rubino on the personality correlates of alexithymia implied that there are several important areas for further discussion. Sociocultural differences in ethnicity (Japanese and Italian) may need to be taken into account for an understanding of the divergent findings.
Patients undergoing physical rehabilitation have experienced a severe object loss and it is suggested that many patients in rehabilitation might have psychiatric disorders. We conducted a study to demonstrate the frequency and kinds of psychiatric and psychological symptoms. A Structured Interview according to the DSM-III-R was conducted, which demonstrated that 27 (43.5%) out of 62 rehabilitation inpatients met the criteria for some form of psychiatric disorders; 22 patients for major depression and five for adjustment disorder with anxious mood. The remaining 35 patients (56.5%) showed normal reactions to their diseases. They were also administered Zung's Self-rating Anxiety Scale (SAS), Zung's Self-rating Depression Scale (SDS) and Profile of Mood States (POMS). These three psychological tests were useful in detecting depression or adjustment disorder among rehabilitation patients; but they were not always specific to the type of psychiatric disorders. Patients with higher scores in these inventories should be referred to a psychiatric consultant for detailed examinations and proper treatment if necessary.
A 50-year-old female patient was admitted because of an enormously enlarged spleen and thrombocytopenia. Ultrasonography and magnetic resonance imaging revealed multiple space-occupying lesions in the spleen. She was diagnosed as having Gaucher's disease based on the low level of beta-glucosidase activity in leukocytes and Gaucher's cells present in bone marrow aspirate. Severe hypersplenism necessitated splenectomy. Pathological studies of the excised spleen, including ultrastructural examinations, demonstrated that multiple space-occupying lesions in the spleen were composed of typical Gaucher cells.
The effect of recombinant human interleukin-6 (rhIL-6) on induction of nitrite (NO(-2)) production was investigated in a mouse myeloid leukemia cell line (M1) and a subclone (Mm1). NO(-2) was induced by rhIL-6 (greater than 50 U/ml) in these cell lines. Pretreatment with rhIL-6 (100 U/ml) for 1 day synergistically enhanced the production of NO(-2) in Mm1 by LPS. Furthermore, pretreatment with IL-6 (100 U/ml) shortened the lag time of induction. These results indicate that IL-6 is involved in the regulation of the NO(-2) production in macrophage-like cells.
BACKGROUND AND PURPOSE: For treatment of acute stroke, drug therapy administered systemically has been unreliable due to inadequate delivery of drug into ischemic tissue. We have developed a new method to deliver drugs into the ischemic tissue by retrograde perfusion of the cerebral vein. METHODS: We examined in rats the effectiveness of administering verapamil into ischemic tissue by retrograde perfusion through the cerebral vein, starting 3 hours after occlusion of the middle cerebral artery. Twenty-four Fischer-344 rats with occlusion of the middle cerebral artery were divided into four groups of six rats each. Group A rats had no treatment, group B rats received verapamil intravenously, and groups C and D rats received verapamil by transvenous perfusion of the brain with blood and with saline, respectively. We studied local cerebral blood flow using the autoradiographic method with carbon-14-labeled iodoantipyrine and examined cerebral infarct volume with cresyl violet and Luxol fast blue staining. RESULTS: As compared with group A rats, in groups C and D rats we found a significant and extensive increase of cerebral blood flow in the ischemic cortical and subcortical areas (55-119%, p less than 0.05) and a significant reduction of cerebral infarct volume (31-39%, p less than 0.05). We found no significant changes in group B rats. CONCLUSIONS: This study shows that transvenous perfusion of the brain with verapamil starting 3 hours after occlusion of the middle cerebral artery produces a significantly beneficial effect in rats.
An enzyme-linked immunosorbent assay has been developed to measure human interleukin-6. The assay, based on the avidin-biotin amplified two-step sandwich method, is quick (requiring 4.5 h), sensitive (detecting 9.5 pg/ml) and satisfactory in reproducibility and specificity. It shows good correspondence with the results of bioassays, and it is not affected by serum and plasma components. These results indicate that this ELISA is suitable for application to clinical samples, which is a major advantage over the widely used bioassays.
We investigated, by case-control study, the relevance of psychosocial factors on the prevalence of acute ischemic heart disease (IHD) in middle aged Japanese men. We questioned 109 acute IHD patients and 80 individuals in an age-adjusted sampled control group. Multiple logistic regression analysis showed the following statistically significant factors: hypertension (odds ratio 4.01, p less than 0.001), Type A behavior pattern (2.25, p less than 0.05) and high job demand (2.23, p less than 0.02). No direct influence of family function or social support to the prevalence of acute IHD was apparent. These results suggest that, among men in Japan, Type A behavior pattern and high job demand represent psychosocial risk factors of IHD. Due to the case-control protocol, causal relationships cannot be decided. The limitation of the study design is discussed within that context.
To investigate the relationship between the coronary-prone behavior pattern (Type A behavior pattern) and coronary artery disease, 159 patients were evaluated by coronary angiography (CAG) and the coronary-prone behavior pattern score (CBP score) as well as other coronary risk factors (CRFs). The extent of atherosclerosis was quantified by the number of diseased major arteries and by a coronary atherosclerosis score (CAS) based on an original, quantitative scoring system. Age, obesity index, systolic and diastolic blood pressure, total cholesterol and CBP score were significantly higher and HDL cholesterol was significantly lower in the multivessel disease group than in the other group. Age, systolic and diastolic blood pressure, total cholesterol, HDL cholesterol and CBP score were correlated significantly with CAS. On the other hand, there was no significant correlation between these CRFs and the CBP score. These results strongly suggest that the behavior pattern might be an independent CRFs via the promotion of coronary atherosclerosis.
Three monoclonal antibodies against human interleukin-6 were established and characterized. One antibody was shown to strongly neutralize both the Ig-inducing and hybridoma/plasmacytoma growth activity of interleukin-6. The results of its epitope analysis using protease treated interleukin-6 and immobilized antibody indicated that this neutralizing antibody binds to a peptide corresponding to Leu151-Lys171 of interleukin-6 molecule. Further analysis using synthetic peptides showed that a shorter peptide corresponding to Ala153-Thr162 can also inhibit the binding of the antibody to interleukin-6. These results suggest that this carboxyl-terminal region plays a crucial role in interleukin-6 functions.
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Twenty-six cases with spontaneous carotid-cavernous fistulas were followed up for periods ranging between 4 months and 9 years 8 months. A complete regression of symptoms without reappearance for more than 6 months was noted in 19 cases, a marked improvement in 2 cases, and a moderate regression in 3 cases. In 2 cases, symptoms have continued for 9 years 8 months and for 1 year. The regression of symptoms was usually delayed in patients less than 60 years old, in cases in which the symptoms developed slowly, and in cases with multiple draining veins. According to our observations a regression of symptoms may occur after very slight changes of haemodynamics. Compression of the cervical carotid artery for a short time or a temporary occlusion of the carotid artery by a balloon catheter should be considered as the treatment of choice in the first instance in cases with spontaneous carotid-cavernous fistulas showing relatively low pressure and low flow shunt.
This report presents our experience with autologous cultured human epithelia grafting on burn wounds, burn scars, and skin-graft donor sites in seven patients. Dispersed epidermal cells were cultured with 3T3 cells treated with mitomycin C. After 2 to 3 weeks, cultured epithelia (total 350 to 2250 cm2) were grafted to the wound. The results showed that cultured epithelia grafts did not take so completely compared to the meshed skin grafts used for the coverage of burn wounds. However, cultured grafts placed on aseptic wounds adhered well and showed good appearance. In the histologic findings, normal differentiation of epidermal cells was found. Cultured grafts were bordered from subepidermal granulative tissue with basement membrane. A rete ridge and the adnexal structures were absent in the specimens that adhered to the burn wounds. However, in the specimens that took on abraded wounds, a gently sloping rete ridge and elastic fibers were seen. The histologic findings showed structures resembling normal skin.
This paper outlines the process of development and the clinical usefulness of a screening test for depression. First we developed a draft questionnaire consisting of 13 items, each of which had three answers--(1) often, (2) sometimes, (3) none--, with reference to certain kinds of rating scales. After each answer was quantified by the sigma method, each item was statistically analyzed among 75 depressive patients and 250 almost healthy subjects visiting the AMHTS (Automated Multiphasic Health Testing and Services) center. Then 12 items effective for discriminating between the two groups were computed by discriminant analysis to produce depression scores which varied from 0 to almost 100 in proportion to the severity of depression. This questionnaire was applied to all consultees visiting the AMHTS, and revealed that almost 1% of them showed higher scores than the threshold score. Psychiatric interviews with the subjects suspected of depression indicated that all of them were in the transient maladapted state although only ten out of 16 were referred to a psychiatric outpatient clinic for further examination and treatment. The validity of this questionnaire was also confirmed by the fact that 86% of 50 additional depressive patients showed higher scores than the threshold score.
This was a retrospective study of 285 patients with coronary heart disease and 393 healthy subjects. They were administered a questionnaire composed of 15 items regarding traditional coronary risk factors and 45 items concerning behavior patterns. The 45 multiple-choice questions were computed by multiple regression analysis to develop a coronary-prone behavior pattern score. As a result, the traditional risk factors were reconfirmed and the behavior pattern scores were found to be significantly different between the two groups. The behavior pattern scores were uncorrelated with other risk factors except for cigarettes smoked daily by 40-49 year-old males. Hence, specific behavior patterns can be said to be an independent coronary risk factor also among the Japanese. In order to investigate the relationship between those behavior patterns and the Type A behavior pattern, factor analysis (normal varimax method) was conducted. Comparing three major factors among Americans, Japanese-Americans and Japanese, hard-working and workaholic tendencies were found to be more stressed rather than the hard-driving and competitive components among the Japanese. This property might be a reflection of the Japanese culture which stresses harmonious relationships rather than individualism and competitiveness. As such, it is seen that Type A behavior pattern is necessarily modified according to culture and nationality. Therefore, the authors propose the term "Japanese Type A behavior pattern" for distinction of the modified form of Type A behavior pattern.
This article demonstrates one clinical application of biofeedback treatment with a microvibration (MV) transducer to relieve functional tremors. A MV transducer, a kind of accelerometer, was originally developed to detect invisible tremors from the body surface but this equipment is also utilized to detect visible tremors to convert them to auditory signals. Our method uses almost the same procedure as electromyographic biofeedback treatment. The threshold level for production of auditory signals should be determined as high as possible between the superimposed amplitudes of essential MV and tremor components. As the sessions progress, the predeterminate threshold level should be gradually lowered to almost the same amplitude as MV itself. In determining the threshold, it is more appropriate to utilize records of the frequency band in which the tremor components are described more clearly, in order to remove noises or MV waves of different frequency ranges. Because of the high sensitivity of this accelerometer, such "tremor feedback" treatment can be recommended only if the tremor is present while the patient is resting or remains still.
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